Women's Views on Wet Nursing and Milk Siblinghood: An Example from Turkey

Abstract

Dear Editor:

Wet nursing was common in all cultures. Motives included to preserve the infant's life after maternal death and that of the mother during illness or supposed weakness, to exploit female slaves and restore their working ability after birth, to maintain marital relations by passing the intercourse ban during lactation, and to increase the number of offspring by avoiding lactation amenorrhea.¹ Also, wet nursing can be performed by a friend, relative, or a woman employed by the family.²

In Turkish society, wet nursing first appeared when formulas were not available and has been a legal issue since then. Concubines who breastfed the sultans' children were termed “Daye/Taye” or “milk-grandma.”² Wet nursing is an old tradition of sharing breastfeeding. However, as years passed, wet nursing and milk-sharing practices began to decline.¹ Although practices such as wet nursing are common in the community, there are not enough studies investigating the effects of the prevalence of these practices.

This study was conducted to determine breastfeeding and milk-sharing practices of the community and to reveal their views on wet nursing.

This cross-sectional, analytical study included mothers (n=500) in a city in Eastern Anatolia in Turkey. The mean age of all the participants was 36.3±6.5 years (minimum, 21.0 years; maximum, 61.0 years), and 51.0% had primary school education. In the study, a 29-item questionnaire prepared by the researchers was used. The data were analyzed using Statistical Package for the Social Sciences software (SPSS, Inc., Chicago, IL). In order to conduct the study, mothers' verbal consents were obtained.

The participating women had high levels of fertility. The average number of births was 3.62 (minimum, n=1; maximum, n=14), and of the women included in the study, 96.4% breastfed their children. Findings regarding wet nursing and milk siblinghood among the participating women are summarized in Table 1. As the women's age increases, so does the prevalence of their wet nursing experiences. Education level, place of residence, income, and family type are other important variables affecting wet nursing. But, when the women are compared, no statistically significant difference is observed by groups between them (p>0.05). There is a significant relationship between the variables such as having a milk sibling, having someone else breastfeed their children, how wet nursing is perceived in terms of beliefs, and whether breastfeeding someone else's child is beneficial (p<0.05).

Table 1.

Findings Regarding Wet Nursing and Milk Siblinghood Among the Participating Women and Women's Views on Wet Nursing

	n	%
Findings
Did they know about wet nursing? (n=500)
Yes	392	78.4
No	108	21.6
Did they have a milk sibling? (n=500)
Yes	100	20.0
No	400	80.0
Did they breastfeed someone other than their own children? (n=500)
Yes	85	17.0
No	415	83.0
If yes, who did they breastfeed other than their own children? (n=70)^a
Children of blood relatives	53	75.7
Children of people not related by blood	17	24.3
Why did they breastfeed someone other than their own children? (n=83)^a
The child's mother could not produce any or sufficient breastmilk.	52	62.7
The child's mother died/was sick/was pregnant.	17	20.5
The tradition requires wet nursing.	9	10.8
Their own child refused breastfeeding.	5	6.0
Was your child breastfed by someone else? (n=484)^a
Yes	71	14.7
No	413	85.3
If yes, who breastfed your child? (n=58)^a
Blood relative	33	56.9
Someone not related by blood	25	43.1
Why was your child breastfed by someone else? (n=69)^a
I could not produce any or sufficient breastmilk.	37	53.6
I was sick/pregnant.	14	20.3
Traditions/other	10	14.5
My baby refused breastfeeding.	8	11.6
Women's views on wet nursing
Is wet nursing beneficial? (n=500)
Yes	277	55.4
No	121	24.2
Both beneficial and harmful	39	7.8
I have no idea.	63	12.6
Why is wet nursing beneficial? (n=419)
Good deed	213	50.9
Beneficial for the child	176	42.0
Beneficial for the mother who wet nurses	30	7.1
Why is wet nursing harmful? (n=90)
It is something unfair to my own child.	59	65.5
It is forbidden by religion.	31	34.5
Religious aspect of wet nursing (n=500)
Positive	347	69.4
Negative	108	21.6
I have no idea.	45	9.0
Can milk siblings get married? (n=500)
Yes	24	4.8
No	447	89.4
I have no idea.	29	5.8
Can you wet nurse again? (n=500)
Yes	89	17.8
No	262	52.4
I have no idea.	149	29.8

Numbers in parentheses are those who responded to the question.

In Turkey, the breastfeeding rates determined in this present study are consistent with those of the Turkey Demographic and Health Survey of 2008. In another study conducted in Kayseri, Turkey, 10.7% of the mothers had a wet nurse, and 5.2% had a wet nurse breastfeed their children.³ In another study conducted in South Africa, the majority of the respondents indicated that they had heard about milk siblinghood; however, today, attitudes towards wet nursing have changed, and wet nursing is considered inappropriate because of the fact that human immunodeficiency virus and other viruses could be transferred in breastmilk.⁴ According to Islam too, milk siblings are like brothers and sisters by blood, so milk siblings cannot marry each other.²

In this study, 55.4% of the mothers considered wet nursing beneficial. Probably, religious beliefs affected opinions, because they said wet nursing is a good deed. The fact that not only the wet-nursed child but also his or her mother would benefit from wet nursing is of importance because it means that wet nursing is regarded as a two-sided phenomenon. None of the women referred to the statement that “wet nursing is harmful because some diseases can be transmitted through breastmilk,” which indicates the fact that none of the women was aware that breastmilk can transmit contagious diseases. Breastfeeding poses a risk for the baby because breastmilk might be infected, and the skin contact between the baby and wet nurse can transmit a disease⁴; also, there is chromosomal transition during breastfeeding due to the transport of mRNA.⁵

It was observed that although wet nursing was more common in the past, the rate of having a support from a wet nurse for their children among the women participating in the study decreased over time.¹ This can be explained by the fact that breastfeeding is encouraged in terms of its health benefits and that breastfeeding mothers are supported about continuation of breastfeeding by healthcare workers. If the mother's milk is not sufficient, the baby should be given breastmilk obtained from donors only after it is sterilized.¹

It is recommended that every baby should be breastfed exclusively by the baby's own mother. If the mother's milk supply is reduced or dried up, then the mother's breastfeeding should be re-established through re-lactation, and the data obtained show that nurses/midwives are likely to encounter wet nursing practices and that health workers must assume that wet nursing is still practiced.

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